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Anatomy · Anatomical structures

Tibialis posterior muscle

m. tibialis posterior

Tibialis posterior muscle (m. tibialis posterior) is located in the deep layer of the posterior compartment of the leg. It participates in plantar flexion, supination, and internal rotation of the foot, supports the longitudinal arch, and its tendon reinforces the proximal transverse arch of the foot, passing in the medial retromalleolar region.

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GroupDeep layer of the posterior compartment of the leg
FunctionPlantar flexion, supination, and internal rotation of the foot
Blood supplyPosterior tibial artery
Clinical aspectWeakening of the supporting apparatus of the arches leads to their depression and flattening of the foot
3 min readFor medical studentsUpdated 09/24/2026
Material prepared by WhiteCoat Pro editorial team based on platform study guidesReviewed by medical editor: Aulov A. A., general practitioner · 09/24/2026

Origin and insertion?

  • Origin: posterior surfaces of both bones of the leg and the interosseous membrane.
  • Insertion: mainly onto the navicular and cuneiform bones, partially onto the bases of the II–IV metatarsal bones.

What are the functions of the muscle?

  • Foot movements: plantar flexion, supination, and internal rotation of the foot.
  • Support of the arches: supports the longitudinal arch of the foot. The tendon of the tibialis posterior muscle, together with the tendon of the fibularis longus muscle (m. fibularis longus), reinforces the proximal transverse arch of the foot formed by the tarsal bones.
  • Clinical significance: when the supporting apparatus is weakened, the arch lowers and the foot flattens, leading to flatfoot.
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Blood supply and innervation

  • Blood supply: posterior tibial artery (a. tibialis posterior).
  • Innervation: tibial nerve — n. tibialis (roots L4–S1).

Topography and adjacent structures

  • On the leg: the muscle is located in the deep flexor layer, occupying a central position. Medially to it lies the flexor digitorum longus (m. flexor digitorum longus), and laterally — the flexor hallucis longus (m. flexor hallucis longus).
  • Cruropopliteal canal (canalis cruropopliteus): the initial section of the tibialis posterior muscle delimits the upper outlet of the canal from the inside and below; externally the aperture is bounded by the neck of the fibula, and superiorly by the popliteus muscle.
  • Neurovascular bundle: initially, the posterior tibial neurovascular bundle lies on the posterior surface of m. tibialis posterior. In the lower third of the leg, the muscle and its tendon shift anteriorly, causing the bundle to change position and lie on the flexor digitorum longus.
  • Medial retromalleolar region: here the tendon of the muscle passes closest to the medial malleolus, lying in a groove on its posterior surface. It is followed by the tendon of the flexor digitorum longus.
  • Synovial sheath: the tendon has a synovial sheath (vag. synovialis m. tibialis posterioris). It begins at the base of the medial malleolus and ends at the site of tendon insertion into the tuberosity of the navicular bone.

Clinical diagnostics

  • Assessment of motor function: to objectify muscle weakness in tibial mononeuropathies, the strength of internal rotation of the foot, provided by m. tibialis posterior, is tested.
  • Electromyography (EMG): needle EMG of the tibialis posterior muscle is recommended. The study is performed 3–4 weeks after the onset of symptoms; during this period, maximal changes develop — denervation spontaneous activity, including positive sharp waves and fibrillation potentials.

Class and exam questions

Where does the tendon of the tibialis posterior muscle pass in the ankle region?

In the medial retromalleolar region, it lies closest to the medial malleolus, positioned in a groove on its posterior surface; it is followed by the tendon of the flexor digitorum longus.

How does the tibialis posterior muscle participate in forming the arches of the foot?

It supports the longitudinal arch, and its tendon reinforces the proximal transverse arch together with the tendon of the fibularis longus. When the supporting apparatus weakens, the arch lowers, leading to flatfoot.

Which nerve innervates this muscle and how is its function tested?

The muscle is innervated by the tibial nerve (n. tibialis). To assess motor function, the strength of internal rotation of the foot, provided by m. tibialis posterior, is tested.

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What else to study on this topic

  • Cruropopliteal canal (canalis cruropopliteus)
  • Medial retromalleolar region
  • Tibial nerve (n. tibialis)
  • Arches of the foot and flatfoot

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